| Konstantinos Koutelos, M.d. & Irina Krym Physician, P.c. | |
|
8401 Fort Hamilton Pkwy Brooklyn NY 11209-4805 | |
| (718) 759-0105 | |
| (718) 759-0800 |
| Full Name | Konstantinos Koutelos, M.d. & Irina Krym Physician, P.c. |
|---|---|
| Speciality | Internal Medicine |
| Location | 8401 Fort Hamilton Pkwy, Brooklyn, New York |
| Authorized Official Name and Position | Konstantinos Koutelos (PARTNER) |
| Authorized Official Contact | 7187590105 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Konstantinos Koutelos, M.d. & Irina Krym Physician, P.c. 8401 Fort Hamilton Pkwy Brooklyn NY 11209-4805 Ph: (718) 759-0105 | Konstantinos Koutelos, M.d. & Irina Krym Physician, P.c. 8401 Fort Hamilton Pkwy Brooklyn NY 11209-4805 Ph: (718) 759-0105 |
| NPI Number | 1003909839 |
|---|---|
| Provider Enumeration Date | 10/02/2006 |
| Last Update Date | 09/05/2012 |
| Medicare PECOS PAC ID | 8527022565 |
|---|---|
| Medicare Enrollment ID | O20041118000611 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003909839 | NPI | - | NPPES |
| 01849825 | Medicaid | NY | |
| 01428293 | Medicaid | NY | |
| 01793324 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| 207RC0000X | Internal Medicine - Cardiovascular Disease | (* (Not Available)) | Primary |
| Provider Name | Joseph Racanelli |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1639194921 PECOS PAC ID: 8426941675 Enrollment ID: I20040205000171 |
| Provider Name | John T Rigney |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1255449229 PECOS PAC ID: 6103814272 Enrollment ID: I20040505001559 |
| Provider Name | Adel Ramsey Abadir |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1760407068 PECOS PAC ID: 4880670546 Enrollment ID: I20040624001697 |
| Provider Name | Michele Marie Greco |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1871561076 PECOS PAC ID: 3173503489 Enrollment ID: I20040726000434 |
| Provider Name | Konstanti Koutelos |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1467545269 PECOS PAC ID: 8022077403 Enrollment ID: I20041011000332 |
| Provider Name | Irina Krym |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1669565438 PECOS PAC ID: 8820057201 Enrollment ID: I20041011000347 |
| Provider Name | Donald C Wallerson |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1407885387 PECOS PAC ID: 6204888464 Enrollment ID: I20050222000687 |
| Provider Name | Tejas Parikh |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1750347126 PECOS PAC ID: 1355374703 Enrollment ID: I20050915000584 |
| Provider Name | Boris Novik |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1164552014 PECOS PAC ID: 5991805640 Enrollment ID: I20070712000247 |
| Provider Name | Lawrence Cicchiello |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1740451152 PECOS PAC ID: 6800929969 Enrollment ID: I20110614000741 |
| Provider Name | Nathaniel Margolis |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1073747259 PECOS PAC ID: 4183943889 Enrollment ID: I20150430001808 |
| Provider Name | Vivek V Patil |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1144456484 PECOS PAC ID: 1456670629 Enrollment ID: I20160722000332 |
| Provider Name | Pallavi Cherukuri |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1083905897 PECOS PAC ID: 7719263342 Enrollment ID: I20170417000676 |
| Provider Name | Jawad M Nesheiwat |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1740622455 PECOS PAC ID: 2264789833 Enrollment ID: I20190520001574 |
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